Friday, August 24, 2012

You Don’t Need an Intestinal Biopsy to Diagnose Celiac Disease

Intestinal biopsies have long stood at the front of the line
as the ‘gold standard’ for celiac disease diagnosis. If little pieces removed
from the small intestine failed to reveal major tissue destruction, a patient
was told that they were free of the disease, despite what other factors came
into play.

I have been frustrated by this approach for years because I
have too often seen the devastating effects created by telling someone who was
gluten intolerant that they were ‘okay’ to eat gluten simply because their
biopsy was negative.

An intestinal biopsy does not tend to show positive during
the early stages of celiac disease. Quite the contrary, the disease must be
quite advanced before this insensitive, invasive and expensive test is
positive. That is my greatest complaint. Celiac disease is devastating to many
systems of the body, chief amongst them the digestive tract and the nervous
system. The more advanced the damage the more difficult it is to regain one’s
health.

Not only are we barely diagnosing 5% of those who suffer,
but we typically only do so after the patient has spent a decade seeing
numerous doctors. We then hold out an insensitive test as the standard that
must be met to receive a diagnosis. Ridiculous!

If it was you or a loved one, wouldn’t you want to receive a
diagnosis as soon as possible, before long term damage occurred to your
body? Of course you would.

Two new research studies were just released in the Journal of Pediatric Gastroenterology and
Nutrition both of which fly in the face of conventional thought
regarding intestinal biopsies. Published in May and June this year, these
studies both came to similar conclusions although they took different routes.
They concluded that in the patients they studied a biopsy was unnecessary for
the diagnosis of celiac disease.

The study in May, entitled “A Biopsy Is Not Always Necessary to Diagnose Celiac
Disease”, examined 283 pediatric patients suspected of having celiac disease.
The results of a blood test, tTG, and their response to a gluten free diet was
also investigated.

The conclusion of the research was that
pediatric patients whose tTG lab test is equal to or above 100 U/mL (units per
milliliter) and for whom symptoms improved upon instituting a gluten free diet,
may not need a small intestinal biopsy to confirm their celiac disease.

This is a tremendous step forward in
the diagnosis of celiac disease. I personally let out a “hurrah” at the point regarding
the importance of seeing improvement with a gluten free diet. This is a
contention that I’ve held for a long time but we are only just beginning to see
it given validity in research. Feeling
better on a gluten free diet is a valid diagnostic tool and should not be
ignored.

The second study published in June,
also in the Journal for Pediatric
Gastroenterology and Nutrition was entitled, “HLA-DQ genotyping combined with serological markers for the diagnosis of
celiac disease; Is intestinal biopsy still mandatory?” I know that title is a
mouthful but basically they were looking at combining genetic testing with
blood testing and asking if that was sufficient to diagnose celiac disease,
without a biopsy.

They found the association of genetic
and blood testing to have a very high predictive value for celiac disease. In
fact the numbers approached 99%!

The researchers’ final recommendations
were to omit the biopsy and utilize blood and gene testing instead.

If this area is new to you, then you’ll
just have to trust me when I tell you that these results are a bit earth
shattering in this field. In fact, many would argue with you that such research
even existed, so entrenched are they in an outdated model. But the results are
out, two in the past two months, with more to come I’m sure.

It’s time to confront the facts that
we, as a country, are poor at diagnosing celiac disease and our ‘gold standard’
test has fallen down way too many times to ever regain the ‘gold’ crown.
Doctors in this field shouldn't feel badly about learning more and changing their
opinion as new information comes available. Doctors are supposed to do what
they do for the greatest good of their patients, period.

Please share this information with friends,
family and your doctor. We have a long way to go before we can pat ourselves on
the back for our high diagnostic rate of celiac disease and gluten sensitivity.
But we can make strides by leaving older, less accurate diagnostic modalities
behind us while embracing newer more effective testing.

Contact me with any questions you may
have. I am here to help and task myself with staying on the cutting edge of
this field. Our destination clinic treats patients from across the country as
well as internationally. We would be delighted to assist you.

Hi, after an endoscopy procedure was carried out my doctor got his nurse to call me to tell me it tested positive for celiacs. I found it bizarre that the doctor didn't call himself so I asked to speak wth him. He didn't answer my questions I how damaged the villi was or how advanced the disease was. I asked him what my anaemia levels were as I feel quite anaemic and he said 'they go hand in hand'!

I was also surprised when he told me to give up gluten and see how I feel. Then perhaps once or twice a week I can reintroduce it and see how my symptoms are. This info goes against everything I have read via the net so far! Would be so grateful if anyone can expand on this?!

Dear Anonymous,I am so glad that you wrote in and have found our blog. I would also encourage you to visit our website: www.healthnowmedical.com where there is another blog and it also has a listing of all my you tube videos.

The advice you have been given is almost criminal.

After a positive biopsy, there is no question that you need a gluten-free diet for life. To reintroduce gluten ever, let alone once or twice a week is downright scarey and I'm at a loss of what to think about your doctor.

You truly need to find a new one to help you manage celiac disease successfully. I don't know where you live but we are a destination clinic and we treat patients from across the US and internationally. We'd be happy to offer you a free health analysis if you'd like. Call us at 408-733-0400.

If you don't contact us then please, please find someone who really knows what they are doing. It is vital to your health!

Several years ago I started having all sorts of symptoms that my doctor could never explain. First I was Lactose Intolerant, then I had GERD. Then it was, "I'm not really sure what to tell you"! I finally switched doctors and the first thing he suggested was blood work to test for a gluten intolerance.

My blood work was positive. My doctor happened to be on vacation, and another doctor ordered an Upper Endoscopy. A couple of months later, I had the endoscopy and I remember the doctor telling me that all my symptoms sounded like they were caused by stress. I was so furious with him, because I knew that stress wasn't to blame.

My results from the endoscopy came back negative. My doctor had then retired from Kaiser and I was never diagnosed. I felt that I had a gluten intolerance, but had no one to confirm the diagnosis until about a year later when I had a visit with a new doctor.

I hope we can raise awareness on this issue so more people don't have to suffer.

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Who Are We?

The Gluten Doctors are a group of doctors consisting of MDs, Naturopaths and Certified Clinical Nutritionists.

Two of the doctors, Drs. Rick and Vikki Petersen, authored the bestseller, "The Gluten Effect", a book which exposes the dangers of gluten and provides a path to good health for those with gluten sensitivity.

The Gluten Doctors specialize in the area of digestive problems, especially gluten sensitivity and celiac disease. Their clinic, HealthNOW Medical Center, is located in the heart of Silicon Valley in Sunnyvale, California.